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Fridlund, Bengt
Publications (10 of 104) Show all publications
Valaker, I., Fridlund, B., Wentzel-Larsen, T., Hadjistavropoulos, H., Nordrehaug, J. E., Rotevatn, S., . . . Norekval, T. M. (2019). Adaptation and psychometric properties of the Norwegian version of the heart continuity of care questionnaire (HCCQ). BMC Medical Research Methodology, 19, 1-15, Article ID 62.
Open this publication in new window or tab >>Adaptation and psychometric properties of the Norwegian version of the heart continuity of care questionnaire (HCCQ)
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2019 (English)In: BMC Medical Research Methodology, ISSN 1471-2288, E-ISSN 1471-2288, Vol. 19, p. 1-15, article id 62Article in journal (Refereed) Published
Abstract [en]

Background: Continuity of cardiac care after hospital discharge is a priority, especially as healthcare systems become increasingly complex and fragmented. There are few available instruments to measure continuity of cardiac care, especially from the patient perspective. The aim of this study was (1) to translate and adapt the Heart Continuity of Care Questionnaire (HCCQ) to conditions in Norway, and (2) to determine its psychometric properties in self-report format administered to patients after percutaneous coronary intervention (PCI). Methods: The HCCQ was first translated into Norwegian from the original English version, following a widely used cross-cultural adaptation process. Data were collected before hospital discharge and in a follow-up after 2months. To assess psychometric properties, a confirmatory factor analysis (CFA) was performed and three aspects of construct validity were evaluated: structural validity, hypotheses testing and cross-cultural validation. Internal consistency of the HCCQ subscales was calculated using Cronbach's alpha, while intra-class correlation (ICC) was used to assess test-retest reliability. Additionally, socio-demographic and patient-reported data were collected to correlate with HCCQ scores. Results: Of those included at baseline, 436 (76%) completed the questionnaires after 2months. CFA suggested that the fit of the HCCQ data to a 3-factor model was modest (RMSEA = 0.11, CFI = 0.90, TLI = 0.90). However, convergent validity was satisfactory, based on existing research. Internal consistency was good, as indicated by its Cronbach's alphas: total continuity of care (0.95); informational (0.93), relational (0.87), and management (0.89) continuity. The ICC for the total HCCQ score was 0.80 (95% CI [0.71, 0.87] p<0.001). As indicated by negative care experiences (rated as 1 or 2 on the five-point scale), patients seemed to have limited knowledge about medical treatment, lifestyle modification and follow-up after PCI. Participation in cardiac rehabilitation and longer consultations with the general practitioner after hospital discharge were positively correlated with better continuity of care. Conclusions: Implementation of the HCCQ will likely support healthcare providers and researchers in identifying problem areas of continuity of cardiac care and in evaluating interventions aimed at improving continuity of care.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Cardiac care, Confirmatory factor analysis, Continuity of care, Cross-cultural adaptation, Patient perspective, Percutaneous coronary intervention, Psychometric properties, Validation
National Category
Cardiac and Cardiovascular Systems Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-81697 (URN)10.1186/s12874-019-0706-z (DOI)000461903000002 ()30885143 (PubMedID)
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2019-04-05Bibliographically approved
Instenes, I., Fridlund, B., Amofah, H. A., Ranhoff, A. H., Eide, L. S. P. & Norekval, T. M. (2019). 'I hope you get normal again': an explorative study on how delirious octogenarian patients experience their interactions with healthcare professionals and relatives after aortic valve therapy. European Journal of Cardiovascular Nursing, 18(3), 224-233
Open this publication in new window or tab >>'I hope you get normal again': an explorative study on how delirious octogenarian patients experience their interactions with healthcare professionals and relatives after aortic valve therapy
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2019 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 3, p. 224-233Article in journal (Refereed) Published
Abstract [en]

Background: Delirium affects nearly half of octogenarian patients after aortic valve replacement, resulting in impaired cognition, reduced awareness and hallucinations. Although healthcare professionals and relatives are often present during episodes, the nature of interactions with them is scarcely studied, and little is known about their long-term experiences. Purpose: The purpose of this study was to explore and describe how octogenarian patients with post-aortic valve replacement delirium experience interactions with healthcare professionals and relatives within the first year and four years later. Method: An explorative design with qualitative content analysis was used. Delirium was assessed for five consecutive days after aortic valve replacement using the Confusion Assessment Method. Delirious patients (n=10) were interviewed 6-12 months post-discharge and four years later (n=5). We used an inductive approach to identify themes in transcribed interviews. Findings: An overarching theme emerged: 'Healthcare professionals' and relatives' responses made a considerable impact on the delirium experience postoperatively and in a long-term'. Three sub-themes described the patients' experiences: 'the need for close supportive care', 'disrespectful behaviour created a barrier' and 'insensitive comments made lasting impressions'. Having healthcare professionals and relatives nearby made the patients feel secure, while lack of attention elevated patients' emotional distress. Four years later, patients clearly recalled negative comments and unsupportive actions in their delirious state. Conclusions: Healthcare professionals and relatives have an essential role in the aortic valve replacement recovery process. Inconsiderate behaviour directed at older patients in delirium elevates distress and has long-term implications. Supportive care focused on maintaining the patients' dignity and integrity is vital.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Delirium, octogenarian patients, qualitative research, surgical aortic valve replacement, transcatheter aortic valve replacement
National Category
Nursing Cardiac and Cardiovascular Systems
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-81084 (URN)10.1177/1474515118810622 (DOI)000459871100007 ()30379104 (PubMedID)
Available from: 2019-03-15 Created: 2019-03-15 Last updated: 2019-03-15Bibliographically approved
Pettersen, T. R., Fridlund, B., Bendz, B., Nordrehaug, J. E., Rotevatn, S., Schjott, J. & Norekval, T. M. (2018). Challenges adhering to a medication regimen following first-time percutaneous coronary intervention: A patient perspective. International Journal of Nursing Studies, 88, 16-24
Open this publication in new window or tab >>Challenges adhering to a medication regimen following first-time percutaneous coronary intervention: A patient perspective
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2018 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 88, p. 16-24Article in journal (Refereed) Published
Abstract [en]

Background: Percutaneous coronary intervention is the most common therapeutic intervention for patients with narrowed coronary arteries due to coronary artery disease. Although it is known that patients with coronary artery disease often do not adhere to their medication regimen, little is known about what patients undergoing percutaneous coronary interventions find challenging in adhering to their medication regimen after hospital discharge. Objectives: To explore patients' experiences in adhering to medications following early post-discharge after first-time percutaneous coronary intervention. Design: An abductive qualitative approach was used to conduct in-depth interviews of patients undergoing first-time percutaneous coronary intervention. Settings: Participants were recruited from a single tertiary university hospital, which services a large geographical area in western Norway. Patients fulfilling the inclusion criteria were identified through the Norwegian Registry for Invasive Cardiology. Participants: Participants were patients aged 18 years or older who had their first percutaneous coronary intervention six to nine months earlier, were living at home at the time of study inclusion, and were prescribed dual antiplatelet therapy. Patients who were cognitively impaired, had previously undergone cardiac surgery, and/or were prescribed anticoagulation therapy with warfarin or novel oral anticoagulants were excluded. Purposeful sampling was used to include patients of different gender, age, and geographic settings. Twenty-two patients (12 men) were interviewed between December 2016 and April 2017. Methods: Face-to-face semi-structured interviews were conducted, guided by a set of predetermined open-ended questions to gather patient experiences on factors relating to medication adherence or non-adherence. Transcribed interviews were analysed by qualitative content analysis. Findings: Patients failed to adhere to their medication regimen for several reasons; intentional and unintentional reasons, multifaceted side effects from heart medications, scepticism towards generic drugs, lack of information regarding seriousness of disease after percutaneous coronary intervention, psychological impact of living with coronary artery disease, and these interacted. There were patients who felt that the medication information they received from physicians and nurses was uninformative and inadequate. Side effects from heart medications were common, ranging from minor ones to more disabling side effects, such as severe muscle and joint pain and fatigue. Patients found well established medication taking routines and aids to be necessary, and these improved adherence. Conclusion: Patients undergoing first-time percutaneous coronary intervention face multiple, interacting challenges in trying to adhere to prescribed medications following discharge. This study highlights the need for a more structured follow-up care in order to improve medication adherence and to maximise their self-care abilities.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Coronary artery disease, Percutaneous coronary intervention, Qualitative research, Medication adherence, Patient-centered care
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-79746 (URN)10.1016/j.ijnurstu.2018.07.013 (DOI)000454965600003 ()30165236 (PubMedID)
Available from: 2019-01-23 Created: 2019-01-23 Last updated: 2019-01-23Bibliographically approved
Pettersen, T., Schjott, J., Bendz, B., Fridlund, B., Nordrehaug, J. E., Rotevatn, S. & Norekvaal, T. M. (2018). Discontinuation of drug treatment due to side effects after first-time percutaneous coronary intervention: a patient perspective.. European Journal of Cardiovascular Nursing, 17, 58-59
Open this publication in new window or tab >>Discontinuation of drug treatment due to side effects after first-time percutaneous coronary intervention: a patient perspective.
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2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, p. 58-59Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Sage Publications, 2018
National Category
Cardiac and Cardiovascular Systems Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-77382 (URN)000440339600100 ()
Available from: 2018-08-30 Created: 2018-08-30 Last updated: 2018-08-30Bibliographically approved
Svensson, A., Almerud Österberg, S., Fridlund, B., Stening, K. & Elmqvist, C. (2018). Firefighters as First Incident Persons: breaking the chain of events and becoming a new link in the chain of survival. International Journal of Emergency Services, 7(2), 120-133
Open this publication in new window or tab >>Firefighters as First Incident Persons: breaking the chain of events and becoming a new link in the chain of survival
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2018 (English)In: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 7, no 2, p. 120-133Article in journal (Refereed) Published
Abstract [en]

Purpose In order to shorten the response time, two part-time fire departments (FDs) in Sweden initialize a first incident person (FIP) assignment. This is done by alarming the crew manager as an FIP, responding in a separate emergency vehicle, and by arriving at the scene before rest of the crew. The purpose of this paper is to explore and describe experiences of the FIP assignment within an FD. Design/methodology/approach A multimethod design was used, influenced by Creswell and Plano Clark's (2011) explanatory sequential mixed method design including emergency reports, a questionnaire and interviews. Findings The results show that the FIP assignment was a function that secured an early presence at the scene of an accident or emergency situations, which is beneficial for society in the form of a safety factor, for the firefighters in the form of early prior information on what to expect at the scene and for the patient in the form of early existential support and increased chances of survival. Originality/value In order to prevent full scenarios to happen and get the chance to save lives, an early response must be ensured. Hence, studies must be made in different settings, based on its unique conditions. This study indicates that by implementing FIP in FDs placed in a rural area, the FIP can break the chain of events and becoming a new link in the chain of survival.

Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Other Medical Sciences
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-69815 (URN)10.1108/IJES-10-2017-0051 (DOI)000432829500004 ()
Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2019-01-16Bibliographically approved
Wallin, K., Fridlund, B. & Thorén, A.-B. (2013). Prehospital Emergency Nursing students’ experiences of learning during prehospital clinical placements. International Emergency Nursing, 21(3), 197-203
Open this publication in new window or tab >>Prehospital Emergency Nursing students’ experiences of learning during prehospital clinical placements
2013 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 21, no 3, p. 197-203Article in journal (Refereed) Published
Abstract [en]

Clinical placements play an important role in learning a new profession, but students report about poor placement experiences. Standards have been laid down for improvements within clinical training in Prehospital Emergency Nursing programmes in Sweden, but no studies have been carried out in this field in a Swedish context. The purpose of this study was thus to describe the experiences of Prehospital Emergency Nursing (PEN) students of their clinical placement and the effect on their learning process. Data were collected in 28 individual interviews and analyzed in accordance with Flanagan’s Critical Incident Technique. Three main areas emerged: the professional clinical supervisor, the clinical placement setting and the learning strategy. All these areas played a significant role in the PEN students’ learning progress and development into a new professional role. The choice of clinical supervisor (CS) and clinical placement is important if PEN students’ learning is to be an effective and positive experience. The prehospital environment is unique and can have positive and negative effects on student learning depending on the support and structure given during their clinical placement. A learning strategy based on reflective dialogue, CS continuity and a learning structure based on the prehospital environment is presented.

Keywords
Prehospital Emergency Nursing, Students, Experience, Prehospital clinical placement, Learning environment, Clinical supervisor, Education, Ambulance, Critical Incident Technique
National Category
Nursing Learning
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-29192 (URN)10.1016/j.ienj.2012.09.003 (DOI)000330158300010 ()2-s2.0-84880044106 (Scopus ID)
Available from: 2013-10-03 Created: 2013-10-03 Last updated: 2017-12-06Bibliographically approved
Elmqvist, C., Fridlund, B. & Ekebergh, M. (2012). On a hidden game board: the patient’s first encounter with emergency care at the emergency department. Journal of Clinical Nursing, 21(17-18), 2609-2616
Open this publication in new window or tab >>On a hidden game board: the patient’s first encounter with emergency care at the emergency department
2012 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 17-18, p. 2609-2616Article in journal (Refereed) Published
Abstract [en]

Aims and objectives.  Describe and understand the patient’s first encounter in emergency care at the emergency department, as experienced by the patient, next of kin and first providers from different professions.

Background.  The emergency department is most often described as having high levels of satisfaction with the quality of care delivered. Although the patients appreciate clinical competence, quick assessment and technical skills, a close connection between patient satisfaction and vulnerability has been shown.

Design.  A lifeworld research perspective was used in four different situations at the emergency department.

Methods.  The data consisted of 14 open-ended interviews with patients, next of kin and first providers.

Results.  The analysis showed that narratives of the past, present and future characterises the encounter where mutual narratives form a foundation for those involved in the encounter. Five constituents further described the variations; vague rules and conflicting expectations in the encounter, an encounter with the biological body, ‘courtesy encounters’, isolated in a timeless encounter, striving for meaning in the encounter.

Discussion.  Instead of expecting the patients to know the unwritten rules of the emergency department, the first providers could give clear information about expected waiting times and what to expect in the encounter. The challenge is to make a meaningful comprehensible context for all involved which can be generated in the interpersonal encounter.

Relevance to clinical practice.  The findings highlight the importance of disclosing the rules of the game by means of giving clear information which would give possibilities for the patient to maintain control, for strengthening the nurse’s role as the patients’ advocate and for strengthening the effort for an emergency department to become more of a learning organisation.

Keywords
emergency care, emergency department, interpersonal communication, interprofessional care, lived experiences, patients' experience, phenomenology
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-17155 (URN)10.1111/j.1365-2702.2011.03929.x (DOI)000307546000023 ()2-s2.0-84865332356 (Scopus ID)
Available from: 2012-01-30 Created: 2012-01-30 Last updated: 2017-12-08Bibliographically approved
Svedberg, P., Johansson, I., Persson, S., Roxberg, Å., Fridlund, B., Baigi, A., . . . Nilsson, U. (2012). Psychometric evaluation of “The 25-item Sex after MI Knowledge Test” in a Swedish context. Scandinavian Journal of Caring Sciences, 26(1), 203-208
Open this publication in new window or tab >>Psychometric evaluation of “The 25-item Sex after MI Knowledge Test” in a Swedish context
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2012 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 1, p. 203-208Article in journal (Refereed) Published
Abstract [en]

The patients’ sexual life after a myocardial infarction is important for his/her quality of life. In spite of this, many patients are in doubt regarding their sex life after a myocardial infarction (MI) and the sexual information received, and counselling from health care providers has been seen to be insufficient. The purpose of this study was to evaluate the psychometric properties of ‘The 25-item Sex after MI Knowledge Test’ in a Swedish context. A convenience sample was recruited. The scale was translated into Swedish and completed by 79 former patients from The Heart and Lung Patients’ National Association on two occasions, with an interval of 2 weeks. The scale was tested for face and content validity, internal consistency and test–retest reliability. The result in this study indicates that the instrument has good face and content validity and displayed a moderate internal consistency (alpha 0.61). The instrument showed some level of instability in test–retest reliability with 60% of the items presenting moderate or strong agreement between the test and retest. Further studies that use this instrument in larger and more diverse samples are thus needed.

Keywords
heart disease, The 25-item Sex after Myocardial Infarction Knowledge Test, validity, reliability
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-11573 (URN)10.1111/j.1471-6712.2011.00909.x (DOI)2-s2.0-84856831914 (Scopus ID)
Projects
SAMMI
Note

Article first published online: 20 JUL 2011

Available from: 2011-05-04 Created: 2011-05-04 Last updated: 2017-12-11Bibliographically approved
Nilsson, U. G., Svedberg, P., Fridlund, B., Alm-Roijer, C. & Thylen, I. (2012). Sex Knowledge in Males and Females Recovering From a Myocardial Infarction: A Brief Communication. Clinical Nursing Research, 21(4), 486-494
Open this publication in new window or tab >>Sex Knowledge in Males and Females Recovering From a Myocardial Infarction: A Brief Communication
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2012 (English)In: Clinical Nursing Research, ISSN 1054-7738, E-ISSN 1552-3799, Vol. 21, no 4, p. 486-494Article in journal (Refereed) Published
Abstract [en]

The purpose of this article was to explore sexual knowledge in persons who had suffered from myocardial infarction (MI). Seventy-six Swedish persons completed the "Sex after MI Knowledge Test" questionnaire. Overall, 53% of the men and 45% of the women scored maximum in the test. In a comparison between sexes, the men scored significantly more often a correct answer compared to the women for two out of the 25 items. The levels of correct answers were less then 50% for 14 out of the 25 items in both sexes. In conclusion we found that people who had suffered MI had poor levels of knowledge about sex and that there were some differences concerning lesser knowledge among the females in comparison to males. In regard to application, using a validated instrument facilitates an interactive communication between the patient and health care professionals, and opens up for a tailored education in line with the patient's and his or her partner's needs.

Keywords
cardiac rehabilitation, myocardial infarction, patient education, sexual knowledge, Sex after MI Knowledge Test
National Category
Sociology
Research subject
Social Sciences, Sociology
Identifiers
urn:nbn:se:lnu:diva-22696 (URN)10.1177/1054773812437241 (DOI)000309562900008 ()2-s2.0-84867089183 (Scopus ID)
Available from: 2012-12-05 Created: 2012-12-05 Last updated: 2017-12-07Bibliographically approved
Bergman, E., Årestedt, K., Fridlund, B., Karlsson, J.-E. & Malm, D. (2012). The impact of comprehensibility and sense of coherence in the recovery of patients with myocardial infarction: a long-term follow-up study. European Journal of Cardiovascular Nursing, 11(3), 276-283
Open this publication in new window or tab >>The impact of comprehensibility and sense of coherence in the recovery of patients with myocardial infarction: a long-term follow-up study
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2012 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, no 3, p. 276-283Article in journal (Refereed) Published
Abstract [en]

Background: After being through a myocardial infarction (MI), a severe recovery period ensues for the patient. Longterm follow-ups are helpful, but what this should include differs between patients. Today there is no established approach to identify needs for support after an MI. Aim: The aim was to describe sense of coherence (SOC) over time in relation to sex, as well as further SOC in relation to quality of life (QoL) and treatment satisfaction in patients with an MI. Methods. This study had an observational and longitudinal design and followed 18 women and 60 men with an acute MI for 49-67 months after the onset of MI. Instruments used were the SOC-13 and the Seattle Angina Questionnaire. Results: Women scored lower SOC than men. A main effect of time was shown for comprehensibility which increased significantly from baseline to the long-term follow-up. Women increased from a lower level to an equal level as men at the long-term follow-up. The total SOC was significantly associated with QoL and treatment satisfaction. Conclusion: High comprehensibility and high SOC give the patient a better basis to handle life after MI. Thus, healthcare professionals should keep in mind that SOC and especially comprehensibility have meaning for the patient's ability to handle her or his recovery. Healthcare professionals need to together with the patient identify and work with lifestyle factors that contribute to increased comprehensibility about the disease, which gives the patient the foundation to preserve and promote her or his health both in the short and long term.

Keywords
Comprehensibility, long-term follow-up, myocardial infarction, quality of life, recovery, sense of coherence
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-23360 (URN)10.1177/1474515111435607 (DOI)000311802200004 ()2-s2.0-84871031073 (Scopus ID)
Available from: 2013-01-09 Created: 2013-01-09 Last updated: 2017-12-06Bibliographically approved
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